Associating Residual First Ray Length With Problems After Isolated First Metatarsal Amputations in Patients With Diabetes

Patients who had first ray amputations for diabetes underwent fewer subsequent amputations if the index amputation maintained greater metatarsal length

Smart Practice: Maintain as much metatarsal length as you reasonably can when performing isolated first ray amputations in patients with diabetes.

What’s the Claim?

A large case series of patients with diabetes undergoing first ray amputations found:

  • After controlling for relevant confounding variables, isolated first metatarsal amputations that maintained >1/3 of the length of the ray were associated with lower odds of transfer amputations of the lesser toes compared with shorter remaining ray length at the index amputation
  • About 2/3 of patients undergoing first ray amputations were readmitted and about 10% had a revision amputation (and based on the study’s design, the actual risk of this probably was much higher)
  • Nearly 1/3 of these patients died at a mean of 3 ± 2 years

How’s It Stack Up?